Background: Fragility fractures of the pelvis (FFP) are a common and increasing fracture type in our aged population1. They are associated with significant morbidity and mortality2 though there is little research describing their characteristics, management and outcomes especially within Australia. The aim of this audit was to describe patient demographics and current management of FFP and assess outcome. A literature search was conducted prior to establish best practice and use as a comparison for current local management.
Method
A retrospective audit was conducted from Jan 2017- June 2017 to identify patients with FFP aged >50 years who presented to a large tertiary and small peripheral hospital. The medical records were analyzed to gather risk factors, patient demographics, investigation, management and outcome.
Results
60 patients were identified, average age 83 years and women were represented four times more than men. All fractures occurred following a fall. Most patients were from home (70%) and a significant number could mobilize independently with nil aids (43%). Management was overwhelmingly conservative with General Medicine admitting most patients and only 3 surgeries occurring. Mean length of stay was 7 days, with complications significantly impacting LOS - mean LOS for patients with complication was 13.0 days vs 7.4 days (p=0.0039). Rehabilitation was needed for 60% of patients and no patients were able to mobilize independently at discharge. Deficiencies in management were identified in investigation of the fracture and osteoporosis treatment
Conclusion
FFP are not benign injuries and are associated with significant morbidity. There appears to be areas of under investigation and treatment in current management especially when hip fractures are used as a comparison for best practice. Improved awareness of poor outcomes and focus on optimal care will be crucial to effective health care expenditure and patient outcomes.